The association between wearable activity monitor metrics and performance status in oncology: a systematic review.

Milan Kos, Esther N Pijnappel, Laurien M Buffart, Britt R Balvers, Caroline S Kampshoff, Johanna W Wilmink, Hanneke W M van Laarhoven, Martijn G H van Oijen

Journal: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 2021;29(11):7085-7099

PMID: 34117567

Abstract

PURPOSE

The expanding armamentarium of wearable activity monitors (WAMs) offers new opportunities to supplement physician-assessed performance status (PS) with real-life patient activity data. These data could guide clinical decision making or serve as a measure of treatment outcome. However, information on the association between physical activity (PA) and sedentary behavior (SB) monitored with wearables (i.e., WAM metrics) and PS in patients with cancer is needed. Therefore, we conducted a systematic review to examine the association between WAM metrics and PS in patients with cancer.

METHODS

We searched MEDLINE and Embase for studies that assessed the association between WAM metrics and performance status among adults with cancer. We extracted information on study design and population, WAM type and different activity metrics, outcome definitions, and results. Included studies were subjected to risk of bias assessment and subsequent best evidence synthesis.

RESULTS

Fourteen studies were included in this review. All studies reported on different combinations of WAM metrics including: daily steps (n = 8), SB (n = 5), mean activity counts (n = 4), dichotomous circadian rest-activity index (n = 3), and time spent in moderate-to-vigorous PA (MVPA) (n = 3). Much heterogeneity was observed regarding study population, WAM used, and reporting of results. We found moderate evidence for a positive weak-to-moderate association between WAM-assessed PA and PS and a weak-to-moderate negative association between WAM-assessed SB metrics and PS.

CONCLUSION

Weak-to-moderate associations between WAM metrics and PS suggest that WAM data and physician-assessed PS cannot be used interchangeably. Instead, WAM data could serve as a dynamic and objective supplement measurement of patients' physical performance.

© 2021. The Author(s).

Address: Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands. [email protected].; Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.; Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Philips van Leydenlaan 15, Nijmegen, The Netherlands.; Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.; Center for Quality of Life, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
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